Melinda Gates wants family planning back on the global agenda

Can Melinda Gates do for family planning what Al Gore did for climate change? Gates has decided to make birth control her signature issue. “My goal is to get this back on the global agenda,” she tells Newsweek. As co-chair of the richest foundation in the world, she might actually be able to do it.

The contraceptive cause could certainly use a high-profile advocate: 215 million women [PDF] around the world want to avoid pregnancy but aren’t currently using modern birth control. As Gates explained last month during a TEDxChange presentation on family planning, “This is a life-and-death crisis. Every year, 100,000 women who don’t want to be pregnant die in childbirth. About 600,000 women who don’t want to be pregnant give birth to a baby who dies in her first month of life. I know everybody wants to save these mothers and babies.”

That TEDx talk was Gates’ coming-out moment as a family-planning champion:

The Bill and Melinda Gates Foundation has funded family-planning projects since its inception in 1999, but it hasn’t been a major focus until now. Melinda Gates says that as she traveled the world on behalf of the foundation over the last decade, she heard over and over again from women in developing countries that they need consistent access to reliable birth control. “I finally said, OK, I’m the person that’s going to do that,” she says.

Gates’ approach is to stress that contraception shouldn’t be controversial. “We’re not talking about abortion,” she said in her TEDx talk. “We’re not talking about population control. What I’m talking about is giving women the power to save their lives, to save their children’s lives, and to give their families the best possible future.” Reports Newsweek, “Part of what Gates hopes to do is to re-create the former broad-based consensus behind global family planning, but in a way that’s focused on women’s needs rather than on demographics.”

Still, Gates did have to get over some Catholic qualms before embracing her new mission. As Newsweek reports,

she went through a lot of soul-searching before she was ready to champion the issue publicly. “I had to wrestle with which pieces of religion do I use and believe in my life, what would I counsel my daughters to do,” she says. Defying church teachings was difficult, she adds, but also came to seem morally necessary. Otherwise, she says, “we’re not serving the other piece of the Catholic mission, which is social justice.”

Even most Catholics would seem to side with Gates on this. Ninety-eight percent of Catholic women in the U.S. use modern birth control, just as Gates herself did when she spaced out the births of her three children.

The Gates Foundation is cosponsoring a family-planning summit for world leaders in London in July, working in tandem with the British government and the U.N. Population Fund. The goal is to start raising $4 billion for the cause, which is what the foundation says it will cost to get contraceptives to 120 million more women by 2020.

The foundation is also investing in research on new contraceptives, a sorely neglected field — and it’s thinking big and bold.

Right now, it’s funding research into contraceptives that women could inject themselves, sparing them onerous clinic trips. Aware that many women reject the birth-control pill because of side effects, the foundation is investing in a search for a contraceptive medication that works without hormones, a “potential whole new class” of drug, says [Gary] Darmstadt, [director of family health at the foundation’s global health program].

Another of the “crazy ideas we’ve been dreaming about,” he says, “is whether we could create an implantable device that would be woman-controlled, and that you could put it in, and it could last her reproductive lifetime.” She could turn it on and off at will, and it would never need to be removed. “That’s something that I think every woman everywhere in the world could potentially benefit from,” he says.

Now that would be revolutionary. But even if the foundation doesn’t hit on that holy grail anytime soon, a boost in awareness and funding for contraceptive access could literally change millions of women’s lives.

“[T]here’s a global movement waiting to happen and ready to get behind this totally uncontroversial idea,” says Gates.

As Gore learned, getting attention is one thing, making actual progress is another. And just because something shouldn’t be controversial doesn’t mean it isn’t. Unfortunately, birth control unites an unholy alliance of opponents, from American right-wingers to the Vatican to Islamic fundamentalists.

All the more reason to join the fight, and Gates could be just the woman to lead the charge.